Assessments often miss mental health issues for youth on probation

“We suspect that the way mental health is often assessed in the juvenile justice system is missing many mental health problems – in particular with disadvantaged youth.”

Patricia Logan-Greene, assistant professor of social work

University at Buffalo

BUFFALO, N.Y. – An assessment tool used by many
jurisdictions within the juvenile justice system that is intended
to help recognize the effects of adversity and trauma in
children’s lives is not the best means of evaluating mental
health problems faced by at-risk youth, according to new study by a
University at Buffalo social work researcher.

The groundbreaking research, which lead author Patricia
Logan-Greene believes is among the first to connect the adverse
childhood experience (ACE) assessment for juveniles on probation to
mental health problems, could help improve the justice
system’s responses to court-involved youth, especially those
who have experienced maltreatment and trauma.

“The United States continues to have a massive juvenile
justice system that does not, generally speaking, serve youth
well,” says Logan-Greene, an assistant professor in
UB’s School of Social Work. “We suspect that the way
mental health is often assessed in the juvenile justice system is
missing many mental health problems – in particular with
disadvantaged youth.”

The number of youth on probation is a far larger group than
those who are incarcerated or in treatment facilities. Yet most of
the research literature is on that smaller population.

“We may have identified a gap,” says Logan-Greene.
“The court assessment asks whether youth have ever been
diagnosed with a mental illness. That question makes a lot of
big assumptions like equal access to health care and equal desire
to access mental health care, which has a lot to do with
stigma.

“A better assessment tool would address
symptomology,” she says.

The problems faced by youth on probation are widespread,
according to Logan-Greene. The vast majority have histories of
child abuse, family dysfunction and social disadvantage.

“Only 25 percent have no history of abuse,” she
says. “One of my elevator speeches argues against punitive
responses for youth with histories of trauma.”

Although most jurisdictions do assess mental health, these are
not necessarily good assessments – and some jurisdictions
aren’t assessing for this at all. A single question to
capture all aspects of mental health simply isn’t
sufficient.

“While the adverse childhood experience tool has done
wonderful things to help us recognize the importance of adversity
and trauma in children’s lives, there is still room for
improvement,” she says. “For instance, there is nothing
in the ACE tool about childhood poverty, and we know from previous
research that childhood poverty is deeply damaging.”

In the current study, Logan-Greene and her co-authors Robert L.
Tennyson and Paula S. Nurius, both from the University of
Washington, and Sharon Borja, University of Houston, divided their
assessment of childhood adversity into childhood maltreatment,
family dysfunction including substance abuse, family history of
mental illness, physical health problems with the family, and
social disadvantage, using a diverse sample of more than 5,300
youth on probation.

The findings suggest a clear connection between childhood
maltreatment and mental health problems. Although there did
not appear to be a relationship between social disadvantage and
mental health problems, there was a connection between mental
health and the symptoms of social disadvantage such as coping
problems, social isolation and what the authors call aspirations or
the measure of hope for the future.

“Because social disadvantage did have a negative effect on
those indicators we suspect the court assessments are not picking
up what are probably undiagnosed and untreated mental health
problems among disadvantaged youth,” Logan-Greene says.